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Early Diagnosis of HSAs

Clinician's Brief (Capsule)

Oncology

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May 2015

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Splenic hemangiosarcomas (HSAs) are common vascular tumors in dogs. As prognosis for these tumors is poor, differentiation from other benign splenic masses would be helpful. It is hypothesized that vascular endothelial growth factor (VEGF) might play a role in growth of these tumors. VEGF is an endothelial cell-specific mitogen that regulates angiogenesis and is stimulated by hypoxia, inflammatory cytokines, growth factors, hormones, and oncogenic mutations. It has been proposed to be a diagnostic marker of malignancy. This study investigated whether serum VEGF could differentiate splenic HSAs from nonmalignant splenic hematomas using a commercial enzyme-linked immunosorbent assay (ELISA). Serum VEGF levels were significantly higher in dogs with splenic masses compared to healthy dogs but did not differ significantly between dogs with HSAs and those with hematomas. This serum ELISA measured VEGF 164 isoform, which may not be the dominant angiogenic factor in HSAs and hematomas. Further studies are necessary to investigate possible roles of other angiogenic factors, including other VEGF isoforms. VEGF has potential clinical utility as a diagnostic marker for dogs with splenic lesions; however, it may not be useful for distinguishing between different types.

Commentary

In the quest to find early markers of neoplasia for diagnosis and/or therapeutic targets, VEGF has been widely studied in patients with cancer, including HSA. Results are controversial, and this test is not helpful in distinguishing neoplasia from benign conditions. Surgical excision and histopathology remain the gold standard for diagnosis and treatment of canine splenic tumors. Early diagnosis may be achievable by regular screening of geriatric patients with bloodwork and imaging; however, the benefit of early diagnosis is unknown in patients with HSA. Our therapeutic arsenal is limited, and the cost of regular screening is high.—Cecilia Robat, DVM, DACVIM (Oncology)

References

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